Document Detail


Patient monitoring and the timing of cardiac arrests and medical emergency team calls in a teaching hospital.
MedLine Citation:
PMID:  16826391     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the timing of cardiac arrest detection in relation to episodes of Medical Emergency Team (MET) review and routine nursing observations. DESIGN AND SETTING: Retrospective observational study in a university-affiliated hospital. PATIENTS: 279 cardiac arrests involving ward patients MEASUREMENTS AND RESULTS: Cardiac arrests were allocated to one of 24 1-h intervals (24:00-00:59, 01:00-01:59, etc.). The actual hourly rate of cardiac arrests was related to the expected average hourly rate. Peak levels of cardiac arrest detection occurred during times of routine overnight nursing clinical observations between 02:00 and 03:00 (OR 3.06) and 06:00-07:00 (OR 1.95). The lowest level of cardiac arrest detection occurred between 20:00 and 21:00 (OR 0.42). After introduction of the MET there were 162 cardiac arrests, 28% of which occurred shortly after an initial MET call. The odds ratio for risk of cardiac arrest during periods of lowest MET activation (24:00-08:00) when compared with periods of highest MET activation (16:00-24:00) was 2.26. CONCLUSIONS: Cardiac arrest detection in our hospital is episodic with peak levels corresponding to periods of overnight routine nursing observations following a period when patient review is likely to be low. After the introduction of the MET there was an inverse link between detection of cardiac arrests and levels of MET activation over the 24-h period. Increased overnight utilization and earlier MET activation may further reduce the incidence of cardiac arrests at our hospital.
Authors:
Daryl Jones; Rinaldo Bellomo; Samantha Bates; Stephen Warrillow; Donna Goldsmith; Graeme Hart; Helen Opdam
Publication Detail:
Type:  Journal Article     Date:  2006-07-07
Journal Detail:
Title:  Intensive care medicine     Volume:  32     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-22     Completed Date:  2007-02-08     Revised Date:  2007-07-12    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1352-6     Citation Subset:  IM    
Affiliation:
Intensive Care, Alfred Hospital, Monash University, Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Circadian Rhythm*
Emergency Service, Hospital / utilization*
Heart Arrest / diagnosis*
Hospitals, Teaching / statistics & numerical data*
Humans
Monitoring, Physiologic / methods*
Outcome Assessment (Health Care)
Retrospective Studies
Time Factors
Comments/Corrections
Comment In:
Intensive Care Med. 2007 Feb;33(2):385-6; author reply 387   [PMID:  17165013 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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